Sports Medicine Feature

High School Football OK to Play Says Mayo Study

Biloine W. Young • Wed, January 4th, 2017

The long-term health of men who played high school football has been unaffected by that high impact sport according to a recent study by researchers at the Mayo Clinic, Rochester, Minnesota. As reported by Dan Gray, writing for Healthline News, playing varsity-level high school football does not carry an increased risk of neurodegenerative diseases compared with other varsity-level sports.

Researchers analyzed the long-term health of 486 student athletes who had played high school sports between 1956 and 1970—296 had played football and 190 had competed in other sports. Students in both groups experienced head trauma, mild cognitive impairment, Parkinson’s disease and dementia but playing football did not appear to carry a significantly higher risk.

But there was a risk. The percentage of former student athletes who experienced head trauma was slightly higher among those who had played football (11% vs. 7%). “It’s somewhat reassuring, ” said Gregory Landry, M.D., a pediatric and adolescent primary care physician from the University of Wisconsin School of Medicine and Public Health. He noted the small sample size and the fact that football has changed a great deal since the ’50s and ’60s.

Landry says that present procedures are a marked contrast to the way concussions were treated in the past.

“I don’t think we recognized that some of these relatively mild head injuries were indeed concussions and that when that happened, a player shouldn’t be in the game, ” he told Gray. “I think that players, coaches, and parents are recognizing concussions much more readily. Any impairment in mental function after a head bonk is a concussion, and athletes should not be practicing or playing if they’re impaired in any way.”

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Concussion Count Worrisome in Grades 8-12

Biloine W. Young • Fri, October 6th, 2017

A survey of 13,088 boys and girls in grades 8, 10 and 12 revealed that nearly 1 in 5 teenagers has been diagnosed at least once with a concussion.

About 6% of the children reported experiencing head trauma multiple times. The study was carried out by a University of Michigan research team. The students responded to a questionnaire as part of the 2016 Monitoring the Future survey, an annual in-school assessment of U.S. students.

“While participation in contact sports can provide numerous health benefits and a way to build confidence and leadership, there is always the risk of concussion,” said Robert Glatter, M.D. a former sideline physician for the Jets and director of sports medicine and traumatic brain injury at Lenox Hill Hospital in Manhattan.

“We also know that between the ages of 10 and 12, the brain is undergoing significant maturation and development. Significant and repetitive trauma at this stage may affect not only brain chemistry and structure, but may lead to long-term neurodegenerative change,” added Glatter, who also is an assistant professor of medicine at Zucker School of Medicine at Hofstra/Northwell. “As a result, it’s best to limit pure collision sports such as football in this age range, replacing it with flag football, until the brain is more fully developed.”

The research team concluded concussions are far more common than has been suggested earlier by data compiled from emergency departments.

In this analysis researchers examined non-contact sports such as swimming and tennis along with the contact sports. They found that athletes were at most risk of suffering a concussion if they participated in football, ice hockey and wrestling. Philip Veliz, Ph.D., lead author of the survey, noted that students need to understand the importance of getting out of a game and not playing when they have been hurt.

According to the publication Newsday, in 2015 there were 383 suspected concussions reported among the 109 high schools who responded to the survey.

The researchers gathered data on first round draft picks from 2008 to 2015 in the National Basketball Association including participation in high school sports, major injuries sustained in the NBA, percentage of games played in the NBA, and whether the athlete was still active in the NBA.

According to the data, out of the 237 athletes evaluated, 36 (15%) were considered multisport athletes in high school. Two hundred and one (85%) were single-sport athletes in high school. The multisport athletes played in more total games than their single-sport counterparts (78.4% vs. 72.8%; p < .001). In addition, the multisport athletes were less likely to be seriously injured during their career (78.4% vs. 72.8%; p < .001). Playing multiple sports in high school was also connected to a longer career in the NBA.

The researchers wrote, “While a minority of professional basketball athletes participated in multiple sports in high school, those who were multisport athletes participated in more games, experienced fewer major injuries, and had longer careers than those who participated in a single sport.”

They called for more research to explore further if there really is a long-term protective effect.

Participation in Sports No Cure for Obesity, High Blood Pressure

Biloine W. Young • Mon, August 29th, 2016

Does participation in student athletics protect young participants from high blood pressure and obesity? According to a recent study published in the Journal of Pediatrics, it does not. Researchers at Thomas Jefferson University found the same rates of obesity and high blood pressure readings in student-athletes as would be expected in the general, non-sports playing adolescent population.

The study grew out of work done by the Athlete Health Organization, a non-profit organization that provides free pre-participation evaluations of student-athletes in Philadelphia each year. Examinations are conducted before the start of the season to identify students who might be at risk for injury, illness or death. Volunteer physicians provide a physical exam including an electrocardiogram. Over a period of four years, the organization has provided physicals to over 2, 700 athletes and caught life-threatening conditions in a handful of students.

"We founded the Athlete Health Organization to promote safe sports activity but we can also use these events to evaluate the overall health of this population, " said David Shipon, M.D., CEO of Athlete Health Organization and a cardiologist at Thomas Jefferson University Hospitals. "This is our first research study and we found alarmingly high rates of obesity and high blood pressure readings among adolescent student-athletes."

Among the team’s finding were the fact that 20% of participants were overweight, 24% were obese and 14.8% had higher than normal blood pressure readings. The students’ body mass index correlated strongly with high blood pressure readings. The researchers found that the numbers were comparable to the general adolescent population.

"Although the general presumption is that athletics and activity should help with weight and blood pressure control, our study suggests that student-athletes in Philadelphia are suffering from these conditions at the same alarming rate as their peers who do not sign up for school sports, " said Jill Kropa, M.D., first author and sports medicine fellow at Thomas Jefferson University.

Elevated Concussion Risk in High School Hockey

Amy Gray Light • Fri, January 22nd, 2016

The old adage “the bigger they are, the harder they fall” should be modified to “the bigger they are, the harder they hit” when referring to younger adolescent males playing collision sports.

Children grow at different rates. By the time boys are 15 years old, they typically weigh between 90 lbs and 175 lbs and stand between 5 ft. and 6 ft. tall (see growth chart from the Centers for Disease Control at the end of this article).

When 15 year old children play collision sports like ice hockey or tackle football, those differences translate into a wide disparity of injury rates—particularly regarding concussions, an injury that can have a life time effect.

According to a newly released study in the Journal of Pediatrics, when it comes to suffering from concussion, adolescents competing against more physically mature males run a risk of taking nearly 40% longer to recover—54.5 days as opposed to 33.4 days.

Concussion is the most common injury among young male players. The Journal of Pediatrics and USA Hockey Today magazine rates concussion as representing more than 15% of injuries among 9 to 16 year-olds and 25% of injuries among high school players.

The study, which was led by Dr Peter Kriz and co-authored by Cynthia Stein, M.D., Janet Kent, M.D., Danielle Ruggieri, BA, Emilie Dolan, BS, Michael O’Brien, M.D., and William P. Mewhan, III, M.D., enrolled 101 boys between the ages of 9 years to 18 years who had been diagnosed with concussions from playing ice hockey.

The boys were followed at three regional medical centers—Rhode Island Hospital/Hasbro Children’s Hospital, Boston Children’s Hospital, and South Shore Hospital in Weymouth, Massachusetts.

Between September 1, 2012 and March 31, 2015, the children’s symptoms were measured according to the Pubertal Development Scale (PDS). The PDS is a self-assessing rating that for males tracks five areas of growth: height, body hair, facial hair, skin changes, and voice changes. Post-injury studies were done on the young athletes including computerized neurocognitive testing (ImPACT), other neurologic examinations, and a standardized Post-Concussive Symptom Scale.

Sports Injury Rate Rising Among Young

Biloine W. Young • Wed, April 22nd, 2015

At first the concern was about concussions occurring at an increasing rate among young football players. Now the American Orthopaedic Society for Sports Medicine (AOSSM) is reporting two trends that members feel are serious. First is that the number of youth injuries is increasing and, second, the fact that young athletes are experiencing injuries at a younger and younger age—injuries that their doctors were more accustomed to seeing in older pros.

Hollie Deese, writing for The Tennessean, quotes Allen Anderson, M.D., an orthopedic surgeon with Saint Thomas West who said, “It is a very big problem now, and education is the key.” He blames the current high risk of youth sports injuries to overuse and a lack of attention paid to proper injury prevention.

“Education is the key, ” Anderson says. The numbers are startling. According to AOSSM‘s data, about 30 million children participate in sports in school. About 2 million of these suffer injuries, 500, 000 visit their doctor about their injuries and 30, 000 require hospitalization.

Deese wrote that there are about 3.5 million kids under the age of 14 who receive medical treatment for sports injuries, “ and children ages 5-14 account for nearly 40% of all sports-related injuries treated in hospitals.”

Anderson said that overuse injuries are responsible for about half of those injuries that occur in middle school and among high school athletes. According to the CDC [Centers for Disease Control and Prevention], at least half of these injuries are preventable. Since the year 2000, there has been a five-time increase in the number of serious elbow injuries among youth baseball and softball players. Anderson terms it as “almost an epidemic now.”

Deese reports that the AOSSM created the STOP Sports Injuries Program in 2010 to help parents and coaches learn more about the prevention, treatment and long-term consequences of overuse and trauma injury among children. Doctors note that “overuse injuries are completely preventable” and their campaign keeps children on the field playing.

David Geier, M.D., an orthopedic surgeon and contributor to the campaign, said that the number of kids suffering injuries and requiring trips to the ER is just too high.